Request an Appointment

Complete the form below or call the Physician Referral Service toll-free at 888-362-2500 between 8 a.m. and 5 p.m., Monday through Friday.

A Referral Advisor will call you within two business days to assist you in coordinating a new patient appointment with the DMC Physician you have selected.

Note: The Request an Appointment feature connects patients with physicians through a three-way conference call; the Referral Service does not have direct access to physician schedules. If you prefer you may contact the physician office directly.

Step 1

Physician:

- or -

Specialty:

Step 2

Choose a form

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Please use this form if you would like to submit all necessary information for our Advisors to schedule your appointment request & email the confirmed date/time back to you.Please use this form if you only want to submit minimal information. This request will result in a callback from our Advisors to collect the necessary information to schedule an appointment.